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肺部空洞性病变的罕见病因： Richter 转化。

A Rare Cause of Cavitary Lesion in the Lung: Richter's Transformation.

作者信息

Yıldırım Fatma, Kara İskender, Yıldız Sedat, Akyürek Nalan, Acar Kadir, Türkoglu Melda, Aygencel Gülbin

机构信息

Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.

Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

Case Rep Pulmonol. 2015;2015:945268. doi: 10.1155/2015/945268. Epub 2015 Feb 24.

DOI:10.1155/2015/945268
PMID:25810941
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4354960/
Abstract

Richter's transformation (RT) refers to the development of aggressive lymphoma during the course of CLL. Clinically, patients with RT present with an aggressive disease course with rapidly enlarging lymph nodes, hepatosplenomegaly, and elevated serum lactate dehydrogenase levels. But rarely it presents with extra nodal organ involvement at the beginning. Common sites of extra nodal involvement are the gastrointestinal tract, eye, central nervous system, lung, and kidney. We are reporting this case that was presented with RT in the lung involvement diagnosed while researching cavitary lesion etiology.

摘要

里氏转化（RT）是指在慢性淋巴细胞白血病（CLL）病程中侵袭性淋巴瘤的发生。临床上，RT患者表现为侵袭性病程，伴有淋巴结迅速肿大、肝脾肿大和血清乳酸脱氢酶水平升高。但很少有患者一开始就出现结外器官受累。结外受累的常见部位是胃肠道、眼睛、中枢神经系统、肺和肾脏。我们报告了这例在研究空洞性病变病因时诊断为肺部受累的RT病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/f2e8bb4835a9/CRIPU2015-945268.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/cd26e40cfced/CRIPU2015-945268.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/6cd44e951fac/CRIPU2015-945268.002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/1c285b8e881b/CRIPU2015-945268.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/9ffc137489aa/CRIPU2015-945268.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/5b1104afd6e5/CRIPU2015-945268.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/f2e8bb4835a9/CRIPU2015-945268.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/cd26e40cfced/CRIPU2015-945268.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/6cd44e951fac/CRIPU2015-945268.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/0cdc39a77110/CRIPU2015-945268.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/1c285b8e881b/CRIPU2015-945268.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/9ffc137489aa/CRIPU2015-945268.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/5b1104afd6e5/CRIPU2015-945268.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cd/4354960/f2e8bb4835a9/CRIPU2015-945268.007.jpg

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引用本文的文献

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本文引用的文献

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Richter's transformation to diffuse large B-cell lymphoma: a retrospective study reporting clinical data, outcome, and the benefit of adding rituximab to chemotherapy, from the Israeli CLL Study Group.里希特转化为弥漫性大 B 细胞淋巴瘤：以色列 CLL 研究组回顾性研究报告临床数据、结局以及在化疗中添加利妥昔单抗的获益。
Am J Hematol. 2014 Nov;89(11):E218-22. doi: 10.1002/ajh.23826. Epub 2014 Sep 2.
2
Richter's syndrome: Utility of ¹⁸F-FDG PET/CT.里氏综合征：¹⁸F-FDG PET/CT的应用价值
Rev Esp Med Nucl Imagen Mol. 2013 Mar;32(2):102-4. doi: 10.1016/j.remn.2012.08.001. Epub 2012 Oct 6.
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Biological and clinical risk factors of chronic lymphocytic leukaemia transformation to Richter syndrome.
慢性淋巴细胞白血病向里斯特综合征转化的生物学和临床危险因素。
Br J Haematol. 2008 Jun;142(2):202-15. doi: 10.1111/j.1365-2141.2008.07166.x. Epub 2008 May 19.
4
Recent advances in the diagnosis and therapy of Richter's syndrome.里氏综合征诊断与治疗的最新进展
Med Oncol. 2007;24(1):17-32. doi: 10.1007/BF02685899.
5
Detection of Richter's transformation of chronic lymphocytic leukemia by PET/CT.通过PET/CT检测慢性淋巴细胞白血病的 Richter 转化
J Nucl Med. 2006 Aug;47(8):1267-73.
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Richter's syndrome: biology and therapy.里氏综合征：生物学与治疗
Cancer J. 2005 May-Jun;11(3):161-74. doi: 10.1097/00130404-200505000-00001.
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Richter syndrome: biology, incidence, and therapeutic strategies.里氏综合征：生物学、发病率及治疗策略
Cancer. 2005 Jan 15;103(2):216-28. doi: 10.1002/cncr.20773.
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Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte-macrophage-colony stimulating factor (GM-CSF) alternating with methotrexate and cytarabine plus rituximab and GM-CSF in patients with Richter syndrome or fludarabine-refractory chronic lymphocytic leukemia.对于Richter综合征或氟达拉滨难治性慢性淋巴细胞白血病患者，采用环磷酰胺、长春新碱、脂质体柔红霉素、地塞米松联合利妥昔单抗及粒细胞巨噬细胞集落刺激因子（GM-CSF），与甲氨蝶呤、阿糖胞苷联合利妥昔单抗及GM-CSF交替使用。
Cancer. 2003 Apr 1;97(7):1711-20. doi: 10.1002/cncr.11238.
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Phase II study of fludarabine, cytarabine (Ara-C), cyclophosphamide, cisplatin and GM-CSF (FACPGM) in patients with Richter's syndrome or refractory lymphoproliferative disorders.氟达拉滨、阿糖胞苷（Ara-C）、环磷酰胺、顺铂和粒细胞巨噬细胞集落刺激因子（FACPGM）治疗里氏综合征或难治性淋巴增殖性疾病患者的II期研究。
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